• Journal of Oral Medicine and Pain
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• 제25권1호
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• pp.73-85
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• 2000

The purposes of the study were (1) to see if there are various types of disc configuration in normal temporomandibular joint and, if so, (2) to examine whether a specific type of disc configuration is susceptible to disc displacement, and (3) to see if a specific type of disc configuration and position is related to early relief of clinical symptoms from the anterior disc displacement without reduction to conservative treatment. From the magnetic resonance (MR) images taken for the patients with symptoms of temporomandibular disorders, 235 images as normal joint group, 255 images as anterior disc displacement with reduction group, and 249 images as anterior disc displacement without reduction group were selected, After the TMJ image was scanned and processed with Photoshop program, the disc configuration was determined, The incidence of various types of disc configuration was analyzed according to age, sex, diagnostic group, and the promptness of symptom relief. The disc position was also examined in relation to the promptness of symptom relief. The results were as follows : 1. In the normal joint group, biconcave type appeared most frequently and reversed, biplanar type in order, Posterior band enlarged and folded type didn't appear at all. On the other hand, in the anterior disc displacement without reduction group, folded type appeared most frequently and also posterior band enlarged type were found often. 2. There were statistically significant differences between sex and configuration of disc in the normal joint group and no statistically significant differences in the anterior disc displacement with reduction group and anterior disc displacement without reduction group, 3. There were no statistically significant differences between age and configuration of disc in the normal, anterior disc displacement with reduction group and anterior disc displacement without reduction group. 4. In anterior disc displacement without reduction group, rapid response was observed in biconcave and reversed type and delayed response was observed in folded type.

• 구강회복응용과학지
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• 제37권4호
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• pp.225-231
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• 2021

목적: 측두하악장애 환자에게 주로 사용되는 장치 치료의 적응증 및 효과에 대한 연구는 다수 존재하나, 증상 개선에 따라 장치를 테이퍼링하여 종료하는 방법에 대한 연구는 부족하다. 따라서 본 후향적 연구는 측두하악장애 환자를 대상으로, 증상 개선에 따라 장치를 테이퍼링하여 종료하는 과정을 고찰하고자 한다. 연구 재료 및 방법: 턱관절 질환, 근막 통증, 이갈이 및 이악물기 등을 주소로 연세대학교 치과대학병원 구강내과를 내원하여 장치 치료(교합안정장치, 전방위치교합장치)를 시행한 130명의 환자의 차트 리뷰를 통해 장치 치료를 테이퍼링하여 종료하는 과정을 알아보았다. 결과: 평균 장치 장착 기간은 29개월로, 매일 장치를 장착한 기간은 8.4개월, 일주일에 3 - 4일간 장치를 장착한 기간은 9.5개월, 일주일에 1 - 2일간 장치를 장착한 기간은 11.1개월이었다. 결론: 측두하악장애 환자에서 장치 장착 시 처음 6개월 간은 매일 장착, 이후 6개월에서 18개월 동안은 일주일에 3 - 4일간 장착, 18개월 이후부터는 일주일에 1 - 2일간 장착하는 방식으로 테이퍼링하여 장치 치료를 종료할 시 측두하악장애 환자의 증상은 완화시키면서 교합 변화 등의 부작용은 최소화시킬 수 있을 것으로 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권2호
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• pp.136-142
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• 2006

Temporomandibular joint(TMJ) disorders have characteristic clinical findings such as pain, joint sound, and abnormal jaw function. With the rapid progress in TMJ imaging techniques, magnetic resonance imaging(MRI) especially provides the clinician and researcher with the ability to evaluate TMJ disorders(effusion, anterior disk displacement) and the hard and soft tissue of the TMJ. In order to manage the internal derangement of TMJ such as anterior disk displacement, the so-called appliance therapy is commonly used. This technique became the treatment of choice before surgical intervention by many practitioners. The purpose of the present study was to evaluate and determine the efficacy of anterior repositioning splint by means of the change of the position of the disk through pre- and post-treatment MRI. MRI and clinical symptom were carefully recorded in TMJ disorder patients. The relationship between TMJ symptoms such as pain, clicking sound, and disk displacement and effusion in MRI were analyzed. Then, splint therapy was applied for 3 months according to our protocol; at day 1, patients should wear 24 hours, in order to accomodate the splint and then, wearing time is reduced to 12 hours per day for one month. During next 2 months, it is tapered to 8 hours per day according to the evaluation of the clinical symptoms. Post-treatment MRI was obtained after 3 month protocol. This treatment strategy improved the clinical symptoms of TMJ disorder, and effusion and articular disk position showed a significant change. In conclusion, a treatment modality using an anterior repositioning splint therapy is an appropriate method for temporomandibular disorder patients.

• Journal of Oral Medicine and Pain
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• 제17권1호
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• pp.51-60
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• 1992

44 Temporomandibular Disorders(TMDs) patients with non-trauma and non-iatrogenic origin pressented at Wonkwang University Dental Hospital. They were grouped into experimental subjects and 85 persons without TMSDs were classified into control groups. The objectives of this study was to investigate the effects of recent life changes on the symptom severity and treatment course of TMDs. For that purpose, the author used several scales and indices, namely, Social Readjustment Rating Scale(SRRS) devised by Holmes and Rahe, SRRS-Korean revision by Hong and Jeong, Helkimos Anamnestic index, Clinical Dysfunction index, and Visual Analogue Scale treatment index(VAS Ti) transformed from VAS by the author. Data resulted from the investigation were collected by scale or index and processed with SPSS. The obtained results were as follows : 1. Life change units(LCU) and values of indices of experimental group were higher than those of control group. 2. Life change units recorded with SRRS-Korean revision were higher than those with original SRRS in all cases and significant positive correlations existed, between he two Therefore, clinical use of original SRRS in Korea is reliable and valid. 3. In experimental group, LCU were positively correlated with Helkimos Clinical Dysfunction index and VAS treatment index, but in control group LCU were not correlated with any items. From this, increase of life changes in patient with TMDs is likely to aggravate TMJ dysfunction and more likely to complicate treatment course.

• 구강회복응용과학지
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• 제27권3호
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• pp.277-284
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• 2011

본 연구는 국민건강영양조사 제 4기, 2009년 자료 중 19~65세 성인의 자료를 이용하여 성별, 연령별 악관절질환 증상에 대한 실태조사를 실시하였다. 최종적으로 연구에 포함된 연구 대상자는 남성 2,738명, 여성 3,427명, 총 6,165명이었다. 모든 통계 분석은 윈도우용 SPSS 17.0K 프로그램(SPSS Inc., Chicago, USA)을 사용하였다. 성별, 연령, 악관절 질환 증상의 유병률의 분석은 기술통계분석을 실시하였고, 성별, 연령과 악관절질환 증상의 관련성을 알아보기 위해 교차분석을 실시하였다. 연구 결과 TMJ sound의 유병률은 10.1%, TMJ pain의 유병률은 1.5%, TMJ limitation의 유병률은 2.0%였다. 이 세 가지 악관절 질환 증상 중 한 개 이상의 증상을 가지고 있는 경우는 1.2%였다. 성별에 따른 악관절질환의 증상은 여성의 경우 TMJ sound, TMJ pain, TMJ limitation 증상의 유병률이 각각 10.7%, 1.8%, 2.2%로 남성 9.3%, 1.2%, 1.6% 보다 높았으나 통계적으로 유의한 차이는 없었다(p>0.05). 연령에 따른 악관절질환의 증상은 19~24세에서 TMJ sound, TMJ pain, TMJ limitation 증상의 유병률이 각각 18.7%, 3.4%, 4.2%로 다른 연령대에 비해 높은 유병률을 보였다(p<0.05). 또한 성별에 따른 악관절질환의 증상의 수는 '적어도 한 개 이상'의 악관절질환의 증상을 가진 경우, '적어도 두 개 이상', '세 개'의 악관절질환 증상을 가진 경우에서 여성의 유병률이 높았으나 모든 경우에서 통계적으로 유의하지 않았다(p>0.05). 그리고 연령에 따른 악관절질환 증상의 수는 '적어도 한 개 이상'의 악관절질환의 증상을 가진 경우, '적어도 두 개 이상', '세 개'의 악관절질환 증상을 가진 경우가 45세 미만의 경우에서 많은 것으로 나타났으며 이는 통계적으로 유의한 것으로 나타났다(p<0.05).

• Journal of Oral Medicine and Pain
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• 제22권2호
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• pp.359-371
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• 1997

Stress is recognized as a major predisposing and/ or precipitating factor in long-lastig intractable chronic pain, such as temporomandibular disorders, headache, and other psychophysiological disorders. So it is necessary to detect physical and psychological changes induced by stress as soon as possible for positive treatment outcome. This study was performed to investigate the occurrence rate of stress symptoms according to anatomic region, type of symptom, and other personal and social factors. 859 subjects from general population answered the stress symptom questionnaire devised by the author and composed of 50 items. Data from the questionnaire were analyzed statistically with SPSS program and the results obtained were as follows : 1. Oral symptom which showed the highest frequency rate of 38.8% was vesicular lesion of the lip and cheek. The other symptoms with more 20% occurrence rate were ulcerative leion of lip and cheek, toothache, paresthesia of teeth, eruption of tongue, tongue coating and taste change in descending order. 2. In extraoral symptoms, ？데 disturbance was the item which showed the highest frequency rate of 62.0%, and the items for stiffness of suboccipital region and neck, headache, facial swelling, furuncle of face were answered more than 45% of the subjects whereas only 14.0% of the subjucts complained jaw pain under stress. 3. The better one who thought his or her health status was, the fewer items were answered and the difference of symptom frequency by dwelling place and by having hobby were shown in extraoral symptoms only. 4. For relief of stress symptoms, 79.2% of the subjects replied only to take a rest whereas not more than 13, 5% of the subjects visited dental clinic. Correlationship between symptom sites were very high.

• 한국전문물리치료학회지
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• 제26권3호
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• pp.99-105
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• 2019

Background: Although magnetic resonance imaging is accurate, it is expensive to measure the movement of temporomandibular joint. The three-dimensional (3D) motion analysis system is an inexpensive measurement tool. Objects: This study examined the reliability of quantifying the mouth opening and lateral mandibular shift and differences between individuals with and without temporomandibular disorder (TMD) using the hygienic method of surface markers on the skin with 3D ultrasound-based motion analysis. Methods: This study included 24 subjects (12 with and 12 without TMD). Temporomandibular joint motion during mouth opening was recorded using two surface markers with 3D ultrasound-based motion analysis. An intraclass correlation coefficient [ICC (3,k)] was used to confirm the intrarater reliability of quantifying kinematic temporomandibular joint motion, and an independent t-test was used to evaluate differences in maximal mouth opening and lateral mandibular shift between the two groups. Results: Assessment of mouth opening and lateral mandibular shift showed excellent test-retest reliability with low standard error of measurement. The lateral mandibular shift and opening-lateral mandibular shift ratio were significantly increased in the TMD group during maximum mouth opening (p<.05). However, no significant difference in maximal mouth opening was observed between the groups with and without TMD (p>.05). Conclusion: This hygienic and simple surface marker method can be used to quantify the mouth opening and lateral mandibular shift at the end-range of mouth opening. The TMD group showed an increased lateral mandibular shift movement at the end-range of mouth opening. The lateral mandibular shift movement can be regarded as a symptom in the diagnosis and treatment of TMD.

• 한국전문물리치료학회지
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• 제27권2호
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• pp.102-110
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• 2020

Background: There is an opinion that improper postures of the head and cervical spine are associated with temporomandibular joint (TMJ) disorders (TMDs). Objects: The aim of this study was to investigate the proportions among the cervical kyphotic angle, physical symptoms including the pain intensity level of the TMJ, and severity of TMD disability in patients diagnosed with TMD. Methods: Sixty-two subjects participated in the study. The evaluation tools included measurements of the cervical kyphotic angle based on the Ishihara index, pressure pain threshold (PPT) on the TMJ, maximal mouth opening (MMO) without pain, current pain intensity level of the TMJ measured using the Quadruple Visual Analogue Scale (QVAS), Korean TMD (KTMD) disability index, KTMD Symptom Frequency/Intensity Scales (SFS/SIS), and Korean Headache Impact Test-6. Correlation analysis was conducted to investigate the correlations between the cervical kyphotic angle and parameters related to TMJ symptoms. Results: Variables that were significantly correlated with the cervical kyphotic angle were the PPT around the TMJ (r = 0.259, p < 0.05), current pain intensity level of the TMJ based on the QVAS (r = -0.601, p< 0.01), and usual pain intensity level based on the SIS (r = -0.379, p < 0.01). The level of TMD functional disability was significantly correlated with the degree of headache (r = 0.551, p < 0.01), level of PPT of the TMJ (r = -0.383, p < 0.01), pain-free MMO (r = -0.515, p < 0.01), pain intensity level of the TMJ based on the QVAS (r = 0.393, p < 0.01), TMD symptom frequency (r = 0.739, p < 0.01), usual pain intensity of the TMJ (r = 0.624, p < 0.01), and most severe pain intensity of the TMJ (r = 0.757, p < 0.01). Conclusion: There is a positive correlation between the cervical kyphotic angle and PPT and a negative correlation between the current and usual pain intensity levels of the TMJ. The cervical kyphotic angle was a predictor of the pain level, tenderness threshold, and intensity of pain in the TMJ.

• 한국산학기술학회논문지
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• 제21권2호
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• pp.381-387
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• 2020

본 연구는 일부 성인의 정신건강 수준, 평소 구강 습관이 턱관절 증상에 미치는 영향을 살펴보고자 시행하였다. 연구 대상은 2019년 9월 1일부터 30일까지 청년기 성인을 대상으로 설문 조사를 시행하였으며 총 402명을 대상으로 하였다. 그 결과 불안, 우울, 사회적 부적응 영역의 정신건강 수준은 삶의 만족도(p<0.001)와 주관적 건강 상태(p<0.001), 외상 경험(p<0.01)과 유의한 차이를 나타냈다. 턱관절 치료 경험자는 사회적 부적응 영역(p<0.05)의 정신건강 수준에서 유의한 차이를 나타냈다. 턱관절 증상은 여성(p<0.05), 음주자(p<0.01), 외상(p<0.01)과 턱관절 치료 경험자(p<0.001)에서 높게 나타났으며, 통계적으로 유의한 차이를 나타냈다. 정신건강 수준(p<0.001), 구강 습관(p<0.001)과 턱관절 증상(p<0.001)은 모두 양의 상관성을 나타냈다. 구강 습관(p<0.001)이 턱관절 증상에 가장 큰 영향을 미쳤으며 외상(p<0.05)과 턱관절 치료 경험(p<0.001)도 턱관절 증상에 영향을 미치는 것으로 나타났다. 이상의 결과로 볼 때 턱관절 증상을 치료 시 구강 습관을 개선하는 것이 가장 중요하며, 정신건강 상담치료와 평소 생활습관의 개선 노력을 병행하여 턱관절 건강을 효과적으로 개선하고 적용할 수 있는 프로그램의 개발이 필요할 것으로 생각된다.

• 대한치과보철학회지
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• 제29권1호
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• pp.289-303
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• 1991

The purpose of this study is to investigate the correlationship between Pantographic Reproducibility Index(PRI) scores and patterns of mandibular movements by mandibular kinesiograph(MKG) that has been used to diagnose temporomandibular disorders. PRI scores have been measured in normal and symptom groups by tracing Denar mechanical pantograph. Maximum lateral deviation, opening & closing velocity, and clinical rest position of mandibular movements have been analyzed in the same group when the mandible is opened and closed. According to to Helkimo's Dysfunction Index, the students and graduates of College of Dentistry are classified as 6 normal groups and 42 symptom groups. The obtained reslts are as follows : 1. The mean of PRI scores was larger in symptom groups than in normal groups. 2. The mean of maximal laterotrusion in frontal trajectory was larger in symptom groups than in normal groups. 3. There was little significant correlationship observed between PRI scores and patterns of mandibular movements by MKG.